Headache: Addressing Patient Needs Beyond Treatment

This year’s May/June issue of Practical Neurology, devoted to the topic of headache, was developed with a clear purpose: to improve understanding, reduce stigma, and encourage advocacy for people living with primary headache disorders, particularly migraine and cluster headache.

It has been my pleasure to bring together clinicians and researchers with deep expertise in neurology and headache medicine for this issue. I am sincerely grateful to each contributor for their time, insight, and commitment to improving patient care. Collectively, these articles reflect both the science of headache disorders and the lived experience of the patients we serve, reminding us that effective care depends as much on communication and education as it does on treatment selection.

A recurring theme throughout this issue is the importance of accurate diagnosis and naming of the disorder. For many patients, finally having a clear diagnosis provides validation and relief after years of suffering. Strong patient and caregiver education is closely linked to improved treatment response, adherence, and satisfaction with care. Improving how we explain headache disorders—and listening carefully to how patients describe their symptoms—remains one of the most powerful tools we have as clinicians.

This issue also emphasizes patient-centered communication and shared decision-making, including the often-overlooked medicolegal dimensions of care. Headache disorders are often invisible illnesses, and patients frequently feel dismissed or misunderstood. Taking the time to listen, to acknowledge their experience, and to engage them as partners in care can significantly improve outcomes. As clinicians, we have a responsibility to reduce stigma through thoughtful language, education, and empathy.

Cluster headache disorder deserves particular attention. Despite being comparable in prevalence to multiple sclerosis, cluster headache remains profoundly misunderstood, with a significant delay in diagnosis for many patients. Maintaining cluster headache in the differential diagnosis—especially in patients with severe, unilateral, and autonomic-associated pain—is critical. Improving recognition and timely treatment can dramatically change the lives of those affected.

The overlap between migraine and functional neurologic disorders is another important consideration addressed in this issue. Migraine and functional neurologic disorder represent two of the most common diagnoses encountered in general neurology clinics. Although their underlying mechanisms differ, clinical overlap is common, particularly in patients presenting with episodic neurologic symptoms or nonepileptic events. Thoughtful evaluation and careful communication are essential to avoid misdiagnosis and to preserve patient trust.

Ultimately, this issue reflects a shared belief: we can do better for our patients. By reducing stigma, improving education, and strengthening communication, we can positively impact both clinical outcomes and quality of life. I hope this headache edition of Practical Neurology serves as a practical and meaningful resource for clinicians and helps advance compassionate, informed care for patients with headache disorders.